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CPT 44960 Fee Schedule

Last Verified: November 2025

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Appendectomy W Ruptured Appendix
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

23 - Emergency Room

Common Modifiers

None

AS - PA/NP/CNS assistant at surgery

22 - Increased Procedural Services

Complexity LevelHigh
CMS$857.18 Physician Fee Schedule

National average reimbursement for CPT 44960 by major payers:

bcbs

$1,092.11

uhc

$1,157.83

aetna

$1,212.05

cigna

$1,419.34

Preview provider-level rates for...
For billing codeCPT 44960
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 44960

United
44960$1621.001720388465 - WEST ASC, LLC, CAMILLUS SURGERY CENTER273166743 - (NY) WEST ASC, LLC DBA CAMILLUS SURGERY CENTERNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$790.001811076623 - SPARTANBURG SURGERY CENTER, LLC570953005 - (SC) SPARTANBURG SURGERY CENTER LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$4300.001922028265 - ATLANTIC GASTRO SURGICENTER, LLC, T/A ACCESS222280343 - (NJ) ATLANTIC GASTROENTEROLOGY ASSOCIATES, P.A.NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$1274.001215492061 - ADVANCED SPINE CENTER OF WISCONSIN, LLC832438541 - (WI) ADVANCED SPINE CENTER OF WISCONSINWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$408.001114996774 - REDBIRD SQUARE ENDOSCOPY CENTER LLC, DIGESTIVE HEALTH CENTER AT REDBIRD SQUARE752816071 - (TX) REDBIRD SQUARE ENDOSCOPY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$2785.001336790237 - AURORA ENDOSCOPY SURGICENTER, LLC825396997 - (CO) AURORA ENDOSCOPY SURGICENTER LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$430.001326340852 - THE SURGICAL INSTITUTE OF MONROE AMBULATORY SURGERY CENTER LLC, SURGICAL INSTITUTE OF MONROE270843485 - (MI) SURGICAL INSTITUTE OF MONROEMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$465.001619114824 - EAST COLUMBUS SURGERY CENTER LLC311641652 - (OH) EAST COLUMBUS SURGERY CENTER LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$722.001164083911 - EVERETT ROAD ASC, LLC, EVERETT ROAD SURGERY CENTER833542382 - (NY) EVERETT ROAD ASC LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$610.001558327213 - SURGICARE OF JACKSON LTD752162993 - (MS) SURGICARE OF JACKSON LTDMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$372.001942793823 - STARKVILLE SURGERY CENTER LLC465332869 - (MS) STARKVILLE SURGERY CENTER LLCMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$6068.001801309612 - TEXAS HEALTH SURGERY CENTER ROCKWALL, LLC474425996 - (TX) TEXAS HEALTH SURGERY CENTER ROCKWALL LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$1274.001225375587 - GCSA AMBULATORY SURGERY CENTER, LLC, GASTROENTEROLOGY CONSULTANTS OF SAN ANTONIO - STONE OAK611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$112.001780604694 - CLEARVIEW SURGERY CENTER INC202828714TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
44960$1572.001972045243 - CARDIOVASCULAR CENTER OF TEXAS, LLC611806430 - (TX) CARDIOVASCULAR CENTER OF TEXAS LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 44960 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 44960 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 44960 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
44900-CPTModerateI & D Of Appendiceal Abscess, Transabdom
44950-CPTModerateAppendectomy
44960-CPTHighAppendectomy W Ruptured Appendix
44970-CPTModerateLaparoscopy; Appendectomy

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44960. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 44960 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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